Qualitative insights into behavioural risks for Taenia solium

In low- or middle-income countries, neglected tropical diseases like taeniasis/cysticercosis from Taenia solium have serious health, social and economic consequences. Despite urgent calls from WHO and governments for intensified control of T. solium, this remains challenging in practice. Intervention failures point to gaps in understanding about behaviours relating to T. solium risk and the critical need for insight into these behaviours. In this study we explored known behavioural risks associated with T. solium in northern Lao PDR. A qualitative assessment was conducted in 28 villages using group discussions, interviews and observation involving 438 people (female:male ratio of 35:65). The study identified a range of contextual and socio-cultural factors influencing risky behaviours, including previously unreported aspects. Raw pork is consumed by people from all four main ethnolinguistic groups, with raw pork dishes commonly available at traditional events, but less commonly part of ceremonial practice. Consumption of raw wild pork was frequently reported across the study villages and often preferred because of its taste. Open defecation is most common in places where toilet coverage is low, but the protective factor of toilets is undermined by time spent out of the village and seasonal water shortages. Free-roaming pigs are common seasonally, but less common when sanctions are in place and enforced. However, there are circumstances that result in a relaxing of rules including feed shortages, inadequate pens and traditional beliefs. Understanding these behavioural risks is essential for developing effective strategies to change behaviour and control/eliminate T. solium.